DOI

10.21007/con.dnp.2024.0093

Faculty Advisor

Tracy McClinton, DNP, APRN, AGACNP-BC and Donna Lynch-Smith, DNP, APRN, ACNP-BC, NE-BC, CNL

Document Type

Poster

Publication Date

Spring 4-28-2024

Disciplines

Investigative Techniques | Medicine and Health Sciences | Nursing

Abstract

Decreasing Re-Intubation Rates in Mechanically Ventilated Adult Patients: A Scoping Review

Purpose/Background

Critically ill patients often require mechanical ventilation to support respiratory function. Prolonging mechanical ventilation can increase adverse outcomes. Weaning patients from the ventilator as soon as clinically appropriate can decrease adverse outcomes. The decision to wean mechanical ventilation lacks a standardized approach. This scoping review will evaluate the literature about the effectiveness of a standardized weaning protocol in decreasing the number of reintubations within 72 hours of extubation.

Methods

We conducted a literature search on PubMed, CINAHL, Scopus, and Medline between November 2020 and November 2023 using key terms such as adult, critically ill, intubation, mechanical ventilation, ventilator weaning, reintubation, and others. Inclusion criteria included English language, peer review, and publication within the last ten years. Ten articles were included after rapid critical appraisals.

Results

Ten articles that studied mechanically ventilated adult patients were reviewed between 2006 and 2021. None of the articles found any practices that decreased re-intubation rates. However, most of the articles in this scoping review supported practices that helped decrease time spent on mechanical ventilation, ICU length of stay, and mortality rate.

Implications for Nursing Practice

The evidence gathered from this scoping review showed no benefit in decreasing re-intubation rates in mechanically ventilated adult patients. That does not mean the data lacked benefits for future practice. The evidence showed the benefits of nurse-driven extubation protocols and early extubation to noninvasive positive pressure ventilation. ICU and Pulmonary teams should be shown the benefits of these nurse-driven extubation protocols and the effects they can have on their patients.


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